Can our health system really go downhill any further?


All hopes were abandoned.  In theory, it was supposed to jump start medical care and provide access to the uninsured.  It was the promise of a new day. Every American would have access to good, quality (I really have learned to hate that word), affordable medical care.

I’ll never forget that day.  It was raining hard, and my clothes were soaked through. The air felt particularly raw against my skin. The sky was covered with dark cumulus clouds. That should have clued me in. The weather was not cooperating, and more than one umbrella was whisked away by the wind. Public transportation was slower than usual. There seemed to be a frenzy in the air. It seemed to me that   people were in more of a rush than usual to get home.

When I arrived at my street, it was empty.  Could it be I thought, that people were already home in front of the television waiting for an announcement by the President of the United States?  Three, two, one and finally the television screen cleared up and a tall, distinguished, well-polished man stood against the glass of the television staring into people’s homes.  I could see the rays of light beaming on him as he spoke to the American people, God’s touch as it were.  I listened intensely sitting at the edge of my seat.  I imagined jaws all over the country dropped as mine did as the words came out of his mouth. I could hear hallelujah praises from my neighbor’s apartment and outside my window.

It was downhill from there.  Staunch supporters had begun to question what was happening. I had friends and patient’s whose insurance premiums skyrocketed.  Other people have said that they have insurance but can’t afford it and won’t seek medical care because of out of reach deductibles. There are many I’ve heard say they’d rather pay the fine. Then there’s my neighbor Beverly a 99-year-old woman with dementia, that most people known by another name, who lives alone and doesn’t own a phone or computer. How is she supposed to navigate the system?  Her mail box is full of threatening notices from the government.  I do hope that she won’t fall again necessitating another expensive emergency department visit.

When I see my doctor, he is glued to his computer because of meaningful use, ACO measures and the myriad of electronic documentation requirements that have multiplied over the years to culminate in what we are burdened with today.  As a doctor, I can choose whether to do these things during the office visit or after hours on what should be my own time, usually choosing the later.  Patients, including me, are not satisfied with the 10 to 15-minute visits where their doctor doesn’t really see them anymore.  Doctors like me who have spent the better part of their lives in training and working to be healers are lost and frustrated. At times I can feel the compassion leaching out of my pores and in the next minute, I’m trying desperately to comfort someone.  It is not a job but a calling.  I am like so many others who have dreamed of becoming a doctor since childhood.  The pencil pushers are happy because Doctor X saw 30 patients that day. Patient satisfaction lost, doctor satisfaction lost.

Now we’re in the downhill spiral to a place no one knows with physician burnout and suicide at record numbers.  Most physicians I know show varying degrees of burnout, including myself. Many are not coping well at all. I can’t count the number of times I have wanted to walk out or just throw in the towel. There must be a solution: a fiscally responsible, patient and doctor-centered system.  We can’t go downhill from here, I pray.

Wendi Lovenvirth is a palliative medicine physician.

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